User Expectations and Continuance Intention of mHealth among Community Health Workers in Malawi *

Abstract

This study aimed to explore how user expectations promote or inhibit community health workers (CHWs) intentions to continue using Cstock, as a case study of mobile health (mHealth) in Malawi. To achieve the objectives of the study, a research model is proposed based on the expectation confirmation model, complemented by other theories from the extant literature. The study employed an interpretive case study design, utilising a deductive approach to theory. The study used semi-structured interviews, field notes and observations to gather data. Twelve CHWs were sampled purposively to participate in the study at Chitipa district health facility in Malawi. The study confirmed that to some extent information quality, system quality, and service quality were pre-acceptance expectations that impacted the CHWs on their future benefits and satisfaction with mHealth. The study also noted that users of Cstock formed expectations from trainings, workshops, seminars, and briefings organised by the Cstock vendor/provider, officials from the Ministry of Health and Chitipa district health facility. Most importantly, the study found that satisfaction and post-usage usefulness impacted CHWs to continue using mHealth despite the available alternatives. The findings demonstrate user expectations' role in continuance intention towards the use of mHealth in Malawi. The study's implication points to policymakers and research practitioners the need to focus on understanding user expectations that could promote the successful adoption of mHealth in Africa and beyond.